Effects of Thyroid Hormone Withdrawal and Recombinant Human Thyrotropin on Glomerular Filtration Rate During Radioiodine Therapy for Well-Differentiated Thyroid Cancer

Thyroid ◽  
2015 ◽  
Vol 25 (12) ◽  
pp. 1291-1296 ◽  
Author(s):  
George Barberio Coura-Filho ◽  
Jose Willegaignon ◽  
Carlos Alberto Buchpiguel ◽  
Marcelo Tatit Sapienza
Keyword(s):  
Thyroid Cancer ◽  
Glomerular Filtration Rate ◽  
Thyroid Hormone ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Differentiated Thyroid Cancer ◽  
Radioiodine Therapy ◽  
Thyroid Hormone Withdrawal ◽  
Well Differentiated ◽  
Recombinant Human Thyrotropin

scholarly journals MANAGEMENT OF ENDOCRINE DISEASE: The role of rhTSH in the management of differentiated thyroid cancer: pros and cons

2019 ◽  
Vol 181 (4) ◽  
pp. R133-R145 ◽  
Author(s):  
Luca Giovanella ◽  
Leonidas H Duntas
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Hormone ◽  
Differentiated Thyroid Cancer ◽  
Clinical Role ◽  
Serum Thyroglobulin ◽  
Thyroid Hormone Withdrawal ◽  
Clinical Sensitivity ◽  
Pros And Cons ◽  
Recombinant Human Thyrotropin

The use of recombinant human thyrotropin (rhTSH) testing in the diagnosis and therapy of differentiated thyroid cancer (DTC) has been adopted over the last two decades as an alternative to the classical thyroid hormone withdrawal avoiding the threat of hypothyroidism. Serum thyroglobulin (Tg) measurement is crucial for monitoring DTC patients over time. Until about a decade ago, optimal sensitivity of Tg assays for the detection of smaller disease foci required Tg measurement after thyrotropin (TSH) stimulation, carried out following thyroid hormone withdrawal or rhTSH administration. In very recent years, significant improvements in assay technology have resulted in highly sensitive Tg (hsTg) assays, sufficiently sensitive to obviate the need for rhTSH stimulation in most DTC patients. The aim of this paper is to review and discuss, via a ‘pros and cons’ approach, the current clinical role of rhTSH to stimulate radioiodine (RAI) uptake for treatment and/or imaging purposes and to increase the clinical sensitivity of Tg measurement for monitoring DTC patients when high-sensitive Tg assays are available.

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